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I found out that I was HIV on January 8, 2008. Once I was diagnosed with a CD4 Count of 593 and VL of 26,000, my CD4 Count got higher and VL got lower. That was until October when my CD4 Count was 662 in lieu of 673, and my VL went from 16,000 to around 41,000 due to shingles. Around that time, I was going through a lot of stress on my job as well as my relationship with a HIV-positive person. I just recently got tested again in January. My CD4 Count is 432 and VL is 76,000.

I suspect the couple of time of unprotected sex (ex would take condom off without me knowing a few times until I told him off) may have caused the dramatic change in my numbers. Also, he is on medicine and I am not (yet). And he happened to get shingles recently. That was before I relocated to another state. Talking with him, he states that it is my mental state that has caused my numbers to change. I was assuming he knows what he is talking about because he has been HIV positive for 12 years. Then again, his other actions does not make him so knowledgeable. Can someone school me on this matter? I would ask a doctor, but I just relocated to another state going on two weeks ago for a new job. Please advise.

True VL ranges from 1/3rd - 3 times the test result. This is the limit of the test in terms of accuracy.

CD4 varies a lot, the cells migrate in and out of your veins, and sleep, time of day affects the result. A variation of +/- 100-150 is common, especially when your count is 400-500+.

If anything stress tends to increase your CD4 count modestly in the short term because of immune activation. I agree it's good to reduce stress tho. Exercise counts as stress if it's excessive, like 5+ times a week.

To answer your question, yes. And to qualify, I mean negative and at times debilitating stress. This type of stress can indeed affect your CD4 count. I had a conversation about this with my doctor several years ago and he agreed. Although stress can manifest itself differently with each individual, my experience was a slowed improvement in CD4 counts. Getting a handle on managing stress and engaging in positive life affirming activities proved extremely helpful to me and I saw my CD4 rise. I did not change medications or diet. I am still reaping the benefits today.

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"He is my oldest child. The shy and retiring one over there with the Haitian headdress serving pescaŪto frito."

Stress and depression may make a great difference in the health of people infected with HIV, according to three new reviews of the data on the subject.

Scientists haven't yet proved that personal attitude and mental health directly affect the progress of HIV infection and AIDS. But the research strongly points to a link, said Dr. Gail Ironson, lead author of the one of the reviews.

"We've got enough studies with people followed over time (to show) that it's not a fluke. You can see how consistent the evidence is," said Ironson, professor of psychology and psychiatry at the University of Miami.

Researchers have long tried to understand the link between people's emotional lives and the progression of HIV. Many HIV patients have histories of depression, stress and trauma that could potentially affect their physical health.

The reviews examining these issues were published in the June edition of the journal Psychosomatic Medicine.

In her review, Ironson and a co-author looked at a number of studies examining the effect of factors such as social support, personality and spirituality.

According to one measure of the strength of the immune system, depressed people become susceptible to disease at twice the rate of other patients, she said.

Jane Leserman, professor of psychiatry at the University of North Carolina, found similar results in her review of studies between 1990 and July 2007.

Psychological problems can contribute to worsening health in a variety of ways, such as making it less likely that patients will take their medications as directed, Leserman explained. On the other hand, research suggests that "enhancing stress management can have protective effects in terms of the immune system," she said.

It may sound obvious that stress and depression make people sicker. But "people want the proof, and we're providing the evidence," Leserman said. "Without that evidence, I don't think HIV researchers would really take it that seriously."

Another study in the journal suggests that interventions that improve mental health might also boost the immune health of HIV-infected people. Adam Carrico of the University of California, San Francisco, and Michael Antoni, of the University of Miami, reviewed 14 studies on the subject conducted between 1987 and 2007. They write that, "psychological interventions represent a viable adjuvant treatment that can assist patients with improving psychological adjustment and potentially enhancing immune status."

According to Leserman, researchers could definitively link mental issues to physical health by launching what's known as the "gold standard" of research; a randomized, double-blind study. Hypothetically, researchers could track two randomly chosen groups of HIV patients, some whom are depressed and stressed and others who aren't.

But such a study would require researchers to not let the depressed patients be treated for mental problems, which is ethically and practically not possible. Both Leserman and Ironson believe that it is crucial to boost the health of HIV patients by helping them deal with the mental challenges they face outside of their disease.

"We should not give up on these people," Leserman said. "We should work with them to try to improve their lives."

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Yes, stress can definitely cause CD4s to drop. In my case, after finding out, my initial count was 612 but I was so completely stressed out and scared for those first few weeks that my CD4s dropped to about 300 in just 3 weeks@! I did not have any OI, have not gotten sick at all, so it was not due to any of that, just due to major stress and fear. I've since been able to calm down and the numbers are trending back up (400).

Just to echo one thing. CD4 counts and VL numbers are a photograph in time. Both vary day to day and it would be wrong to fixate on numbers on a given time. Look for trends and not snap-shots. If you did a CD4 count every day of the week, you would find that the numbers vary for one reason or another. It's not wrong to test every now and again, but don't draw conclusions that your numbers are taking a turn for the worse or better based on a single measurment. Look for repeated numbers offering a trend.

R

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NB. Any advice about HIV is given in addition to your own medical advice and not intended to replace it. You should never make clinical decisions based on what anyone says on the internet but rather check with your ID doctor first. Discussions from the internet are just that - Discussions. They may give you food for thought, but they should not direct you to do anything but fuel discussion.

I agree with you there. I think it's perhaps not so much the stress itself, but how one deals with the stress and that gives us a huge gray area. I have mates who don't deal well with stress and every time they get stressed out, they end up with a head cold or stomach bug or similar. Then I have other friends who also get stressed out, but they deal with it differently and they don't end up sick. Maybe it's a thing of whether a person internalises the stress or gets it out of their system through exercise or a hobby or whatever it takes to help them relax.

It's well documented that stress can adversely affect a person's physical health, whether hiv negative or hiv positive. I seems to me that it would make sense that someone whose body is already dealing with something like a chronic illness would be more susceptible to adverse effects of stress.

We all have stress in our lives, to varying degrees. I suspect the answer is not so much to eliminate stress (which would be next to impossible) but to learn what are the most effective ways for us, individually, to lessen the impact of stress on our bodies. What may work for one might not work for another, so it's a case of trial and error to find out what's best for each person. For one it may be sessions in the gym, for another it may be meditation and for yet another, it might be a night out with friends.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

In my case I am not yet on any medications, it's possible that stress alone might not affect numbers too much if you are taking strong antiretrovirals?

During that time mine were only partially working -- it took me 13 years of HIV med regimens to obtain an undetectable viral load, though generally the entire time my cd4 count continued to rise. There's a term for this segment of patients, though I forget what it is, but it's very, very small in numbers.

Bottom line is that it's always good to remove stress, but sometimes we do this as an excuse not to get things done -- there exists "good" stress and "bad" stress if you understand what I mean. Bad stress would, to me, be a situation such as a damaging emotional relationship that you don't get out of and allow it to go on for years and years. Sometimes the same can be said of a job, but many many jobs are stressful and it depends on how you handle it internally.

So, this stress issue in terms of HIV isn't as simple as it sounds. I know some HIV'ers that are always shouting about their "omg stress!" as an excuse to just lie on the couch and meditate 24/7, and that's just simply lame and not a long term solution to how to live with this virus. Hope that makes sense.

Oh, and when in doubt about how you're handling a stress situation why not go to a professional -- there's never a reason to fear that ole shrink's couch, I say.

I have to agree with the stress factor lowering your cd4 count. I was healthy until I change position at my job. The stress of the new position just push me over the edge that I landed in hospital to learn my cd4 count was low.

After that ordeal, I started looking for a new job. I just could not deal with it daily. On top of that, it is still a hostile working environment.